Rapid Endoscopic Diagnosis of Benign Ulcerative Colorectal Diseases With an Artificial Intelligence Contextual Framework.

BACKGROUND & AIMS: Benign ulcerative colorectal diseases (UCDs) such as ulcerative colitis, Crohn's disease, ischemic colitis, and intestinal tuberculosis share similar phenotypes with different etiologies and treatment strategies. To accurately diagnose closely related diseases like UCDs, we hypothesize that contextual learning is critical in enhancing the ability of the artificial intelligence models to differentiate the subtle differences in lesions amidst the vastly divergent spatial contexts. METHODS: White-light colonoscopy datasets of patients with confirmed UCDs and healthy controls were retrospectively collected. We developed a Multiclass Contextual Classification (MCC) model that can differentiate among the mentioned UCDs and healthy controls by incorporating the tissue object contexts surrounding the individual lesion region in a scene and spatial information from other endoscopic frames (video-level) into a unified framework. Internal and external datasets were used to validate the model's performance. RESULTS: Training datasets included 762 patients, and the internal and external testing cohorts included 257 patients and 293 patients, respectively. Our MCC model provided a rapid reference diagnosis on internal test sets with a high averaged area under the receiver operating characteristic curve (image-level: 0.950 and video-level: 0.973) and balanced accuracy (image-level: 76.1% and video-level: 80.8%), which was superior to junior endoscopists (accuracy: 71.8%, P < .0001) and similar to experts (accuracy: 79.7%, P = .732). The MCC model achieved an area under the receiver operating characteristic curve of 0.988 and balanced accuracy of 85.8% using external testing datasets. CONCLUSIONS: These results enable this model to fit in the routine endoscopic workflow, and the contextual framework to be adopted for diagnosing other closely related diseases.

Giant panda (Ailuropoda melanoleuca) neonates use broadband calls to communicate with their mothers.

Infant call structure should have evolved to elicit maximum maternal attention and investment. Neonates of giant pandas produce three types of vocalizations reported to be vitally important in the context of mother-infant communications. However, how cubs, 0-15 days old, communicate with their mothers to elicit maternal care remains unknown. We analyzed 12 different call parameters of 3475 squawks, 1355 squalls, and 491 croaks from 11 captive giant panda (Ailuropoda melanoleuca) neonates from age 0 to 15 days. In playback experiments, we also tested whether mothers could detect ultrasound. Our results show that neonates use broadband calls with ultrasonic frequencies up to 65 kHz to convey information about their physiological needs and to attract maternal care. In playback experiments, we tested if mothers reacted differently to broadband calls (BBC) than to artificially altered calls that included only frequencies <20 kHz (AUDC) or calls that included only frequencies >20 kHz (USC). Playback confirmed that, although adult females responded significantly less often to USC, BBC than to or AUDC, they could detect USC, BBC and generally made appropriate behavioral responses, indicating a potential benefit for neonates to utilize ultrasonic and broadband frequencies. Our findings provide a new insight into mother-infant communication in giant pandas and will be helpful for reducing the mortality of cubs, younger than 1 month old, in captivity.

LTBP2 inhibits prostate cancer progression and metastasis via the PI3K/AKT signaling pathway.

Biochemical recurrence (BCR) is a cause of concern in advanced prostate cancer (PCa). Thus, novel diagnostic biomarkers are required to improve clinical care. However, research on PCa immunotherapy is also scarce. Hence, the present study aimed to explore promising BCR-related diagnostic biomarkers, and their expression pattern, prognostic value, immune response effects, biological functions, and possible molecular mechanisms were evaluated. GEO datasets (GSE46602, GSE70768, and GSE116918) were downloaded and merged as the training cohort, and differential expression analysis was performed. Lasso regression and SVM-RFE algorithm, as well as PPI analysis and MCODE algorithm, were then applied to filter BCR-related biomarker genes. The CIBERSORT and estimation of stromal and immune cells in malignant tumor tissues using expression data (ESTIMATE) methods were used to calculate the fractions of tumor-infiltrating immune cells. GO/DO enrichment analyses were used to identify the biological functions. The expression of latent transforming growth factor ß-binding protein 2 (LTBP2) was determined by RT-qPCR and western blotting. The role of LTBP2 in PCa was determined by CCK-8, Transwell, and the potential mechanism was investigated by KEGG and GSEA and confirmed by western blotting. In total, 44 BCR-related differentially expressed genes (DEGs) in the training cohort were screened. LTBP2 was found to be a diagnostic biomarker of BCR in PCa and was associated with CD4+ T-cell infiltration and response to anti-PD-1/PD-L1 immunotherapy. Subsequently, using the ESTIMATE algorithm, it was identified that LTBP2 was associated with the tumor microenvironment and could be a predictor of the clinical benefit of immune checkpoint blockade. Finally, the expression and biological function of LTBP2 were evaluated via cellular experiments. The results showed that LTBP2 was downregulated in PCa cells and inhibited PCa proliferation and metastasis via the PI3K/AKT signaling pathway in vitro. In conclusion, LTBP2 was a promising diagnostic biomarker of BCR of PCa and had an important role in CD4+ T-cell recruitment. Moreover, it was associated with immunotherapy in patients with PCa who developed BCR, and it inhibited PCa proliferation and metastasis via the PI3K/AKT signaling pathway in vitro.

Identification of Potential Diagnostic and Prognostic Biomarkers for Colorectal Cancer Based on GEO and TCGA Databases.

Colorectal cancer (CRC) is one of the most common neoplastic diseases worldwide. With a high recurrence rate among all cancers, treatment of CRC only improved a little over the last two decades. The mortality and morbidity rates can be significantly lessened by earlier diagnosis and prompt treatment. Available biomarkers are not sensitive enough for the diagnosis of CRC, whereas the standard diagnostic method, endoscopy, is an invasive test and expensive. Hence, seeking the diagnostic and prognostic biomarkers of CRC is urgent and challenging. With that order, we screened the overlapped differentially expressed genes (DEGs) of GEO (GSE110223, GSE110224, GSE113513) and TCGA datasets. Subsequent protein-protein interaction network analysis recognized the hub genes among these DEGs. Further functional analyses including Gene Ontology and KEGG pathway analysis and gene set enrichment analysis were processed to investigate the role of these genes and potential underlying mechanisms in CRC. Kaplan-Meier analysis and Cox hazard ratio analysis were carried out to clarify the diagnostic and prognostic role of these genes. In conclusion, our present study demonstrated that CCNA2, MAD2L1, DLGAP5, AURKA, and RRM2 are all potential diagnostic biomarkers for CRC and may also be potential treatment targets for clinical implication in the future.

[Study on thinking of clinical syndrome differentiation and treatment methods for neck-shoulder pain syndrome].

Neck-shoulder pain syndrome is a commonly-seen disease clinically. Modern medicine has had no better therapy for it yet. Acupuncture and moxibustion have a better therapeutic effect, but improper treatment easily induces protracted course. For the treatment, detailed syndrome differentiation, paying attention to pulse-taking, in combination with local palpation diagnosis and channel palpation, selection of proper acupoints should first be carried out; for manipulation of needling, do not seek first for arrival of qi, but waiting for arrival of qi is important, and warming needle treatment should be combined; for the patient with yang-qi not reaching the four limbs, firstly warming reinforcing yang of the spleen and kidney, then opening the 4 gates, Hegu (LI 4) and Taichong (LR 3) are carried out to promote yang-qi going, and then acupuncture is given at the neck-shoulder based on syndrome differentiation.

[Thinking and methods of treatment of Sjogren's syndrome based on syndrome differentiation of Triple Energizer].

Sjogren's syndrome is one of clinical difficult and complicated diseases and there is no radical treatment for it at present. The authors summarize the thinking of clinical syndrome differentiation and treatment of acupuncture and moxibustion, 4 syndrome-differentiation methods and dredging the Triple Energizer channel, and needling three parts by long-term clinical practice and in combination with clinical study achievements of TCM in recent years, and put the important point of treatment on the Triple Energizer, with the points on the Triple Energizer channel as main points, combined with the points with functions of regulating functional activity of qi and regulating visceral functions, attaining better results. This provides a new method for acupuncture and moxibustion treatment of Sjogren's Syndrome.